How I Ate My Way Through Twin Pregnancy

If you’re reading this, you probably already know there’s no shortage of research on pregnancy nutrition — and most of it applies to twin pregnancies as well. My pregnancies taught me to respect the medical advice while also listening to my body’s constantly changing wants and needs. I lived in tension between (1) what I believed I should be eating, (2) what I actually craved — often things not on the “approved” list, and (3) stretches where I did not want to eat at all.

Naturally, this sparked anxiety. Women are already conditioned to overthink food, so I found myself analyzing both quantity (was I eating enough for two growing babies?) and quality (was I eating the “right” things?). When we eat only for ourselves, we carry the consequences alone. With twins on the way, my priorities shifted instantly. You’d think that once you understand the assignment — eat for growth and development — the choices would be clear. This was not my experience.

I Want to Eat What I Want, When I Want

A few months into my first (singleton) pregnancy, my partner observed that our credit card was being charged exactly 4.97 cents every day at McDonald’s. Living in New York City offers a wealth of food choice, and he had never once seen me gravitate toward McDonald’s apart from the occasional airport meal. I confessed that my pregnancy craving was extraordinarily consistent and specific: I needed one Egg McMuffin plus one hash brown to start the day, every day.  

To be clear, I was ashamed of feeding my in-utero child fast food. Was I also deliriously happy with this high-calorie ritual? Yes. It was the only thing that gave me relief from the relentless hunger and nausea. Was my happiness marred by sizable guilt that I was perhaps poisoning my unborn child? Yes, but I could not see a viable alternative plan.  Pregnancy left me hungry or nauseas at all times, and the daily McDonald’s salt-bomb provided me hours of physical relief from those two symptoms every day. Stressing me out further, many of the healthy foods I used to enjoy (chicken breast, pretzels, oatmeal) were now intolerably disgusting. My ability to taste and smell felt warped by pregnancy.

My very wise obstetrician did not call the authorities on me when I raised the matter. She reminded me that consuming fast food is not the same as abusing vodka or cocaine. My Egg McMuffins provided a decent amount of essential carbs and protein. She pointed out that cravings are not an old wives’ tale, but rather a sign that your body may need a little extra salt or carbs to support pregnancy operations. In other words, promoting fetal growth is the objective and there are various ways to support that goal. So long as I integrated diverse and nutritious food into my diet, I did not need to ignore my cravings or eat purely for utility’s sake. 

• Balance Cravings with Smart Planning. A food need not be entirely virtuous to be useful for pregnancy purposes. To offset my dirty little McDonald’s habit, I kept a Stonyfield Strawberry Smoothie on hand at all times because, with a little honey, it resembles a milkshake. A jar of spicy olives really hit the spot when I was craving flavor but not in the mood to actually eat. Sweet potato fries are filling and deliver some nutritional kick.  The key is to identify your unique list of non-garbage foods you can and will eat. With that list, you know what to keep on hand at all times.

• Look for Quantity Plus Quality. When pregnant with twins, you need more calories than you would with a singleton pregnancy. But gaining weight too fast raises the risk of complications such as gestational diabetes. If you live on a diet of spinach and blueberries, you are providing excellent nutrients but may be short on calories. If you eat glazed donuts all day every day, you’ll definitely meet your calorie count but without all those helpful vitamins and minerals that babies seem to enjoy. Your doctor will monitor your weight and the twins' weights to track everyone’s growth. They will tell you if you need to radically adjust your diet. In the meantime, use common sense and aim for variety.

• Bypass Aspirational Foods. All of us occasionally purchase food we should eat, but most likely won’t. In my case, it was dried lentils. Looking back, I should have asked whether my new healthy food purchases were worth the time required to cook, the expense of extra groceries, and the energy required to prepare a meal. So many missed napping opportunities!  

But What If I Have No Appetite?

My second pregnancy, when I carried twins, was far more complex than my singleton pregnancy. The fatigue hit me like a freight train while I was caring for a two-year old toddler and working full-time. I could not understand, therefore, my complete lack of appetite for most of this pregnancy.  

By now, I had completed three rounds of IVF (the first produced my singleton, the second miscarried, and the third resulted in twins). By pregnancy number three, my body had endured so much more trauma compared to my starting point for baby number one. During my first twin trimester, I took additional meds and hormones to reduce the chance of miscarriage. I was a few years older than before, too. All or some of these variables could have contributed to my waning desire to eat. 

By the end of my first trimester with twins, I had gained less than ten pounds. Was I starving my twins? My doctor said no because they were growing at a good pace according to weekly scans. She explained the twins were burning through far more of my calories than my prior singleton. They were robbing me of those extra calories that ordinarily would have converted into extra pounds on my frame. She warned me, however, that the twins’ caloric and nutritional needs were increasing. To ensure their growth, we had to ensure my own.  

The calorie question escalated by my twenty-fourth week of pregnancy after my doctor placed me on hospital bedrest. The twins were growing, but they were not ready for delivery. My dilating cervix meant that I had to stay in the hospital for several weeks so that the twins’ heart rate could be monitored around the clock.  

By now, I was enormous. At twenty-four weeks I looked nearly the same as I did at thirty-six weeks during my singleton pregnancy. I truly could not reconcile the size of my body with the scant food I was ingesting. Adding to the fun, I felt intense pressure on my ribs and lower back day and night. A full glass of water was enough to trigger burning acid reflux.  And now I was on hospital food for the remainder of my pregnancy.

My bedrest memories are incomplete for a variety of reasons. I do recall that the hospital was renovating their cafeteria, so all meals were prepared elsewhere and delivered to the hospital, akin to airline food. It was predictably terrible, yet I managed to eat enough to deliver twins that are today healthy and thriving.  This is what I recall:

• Do Not Aim for Delicious.  Your relationship with food changes during pregnancy. What used to be a source of pleasure (eating!) became a hard job during twin pregnancy. I forced myself to eat at least one peanut butter and jelly sandwich every day in the hospital to get some nutrition-dense food into my system, even if it took two hours. My family brought me pastries, pizza, and take-out from my favorite restaurants. None of it tasted good, but I forced down a few bites as often as I could. It felt painfully inadequate at the time, but I was giving the twins what they needed.  

• Burning More While Moving Less.  As your pregnancy progresses, your ability to walk, exercise, and work will change. If you end up on bedrest, your activity level goes from 100% to 5% instantly, and you will expend fewer calories because you are moving less. But your body is still working non-stop to grow your twins. The result is that you need to keep the calories flowing in even when you are not creating an appetite due to lack of activity. Start with one almond every 5 minutes. Or one bite of rice pudding. One sip of orange juice. Repeat, repeat, repeat.

• And Don’t Forget the Fluids. Honest to God, I felt like an over-inflated balloon during my last few weeks of pregnancy. I did not want to ingest anything because there was NO MORE SPACE. The arena in my belly was officially at capacity. I recall lifting my water bottle and thinking, “Wow, this is heavy. I cannot put this in my body, there is simply no room at the inn, whatsoever.” I also resented having to get up so frequently to pee, an increasingly cumbersome task given my size. But dehydration spurs fatigue and nausea, which in turn makes it harder to eat and drink. Don’t trigger this cycle. Stay hydrated.  

  
  

In the end, you must eat to live, and you must eat for those babies. Your body will change and it will feel overwhelming. When you address your own needs proactively, you are indirectly making life better and easier for your passengers. Parents have been nourishing babies since the dawn of humanity, which means you can do this. Trust your body, lean on your medical team, and remember — you don’t have to do it perfectly to do it well.  

Author’s Note: This post reflects my personal pregnancy experiences and is shared for informational and storytelling purposes only. It is not intended as medical advice and should not replace guidance from your health care professional. Nutritional needs during pregnancy — especially twin pregnancies — can vary widely. Always consult your healthcare team before making changes to your diet, supplements, or treatment plan.